Prevalence of finding sexual partners online and associations with sexual behaviour and sexual health outcomes: a British national probability survey

Abstract

BackgroundOnline venues provide opportunities to facilitate sexual encounters, but the extent to which finding partners online is associated with risky sexual behaviour and poor sexual health outcomes is unclear; much of the research to date has focused on subpopulations, or convenience samples. We aimed to describe individuals' use of the internet to find sexual partners in a representative sample of the British population. MethodsThe third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) was a cross-sectional probability survey of 15 162 adults aged 16–74 years, which used computer-assisted personal-interview and self-interview, undertaken during 2010–12. The sample was weighted to account for selection probability and non-response, and corrected for differences in demographics according to the UK 2011 census. We estimated the prevalence of, and identified factors associated with, finding sexual partners online in the past year among 5698 men and 8198 women who reported sexual experience ever. FindingsUse of the internet to find sexual partners in the past year was reported by 5·2% of men (95% CI 4·7–5·8) (unweighted n=389) and 2·4% of women (2·1–2·8) (unweighted n=249), and was associated with younger age. After adjustment for age, individuals reporting a non-heterosexual identity (adjusted odds ratio for men 8·87, 5·95–13·22; for women 3·56, 2·20–5·78) were more likely to report finding partners online. This outcome was also associated with reporting sexual risk behaviours including sex without a condom with two or more partners (men 5·24, 3·71–7·39; women 6·36, 4·25–9·53), reporting five or more partners (11·19, 6·36–19·67; 17·44, 7·32–41·52), and reporting a new partner (13·27, 9·49–18·54; 14·93, 9·97–22·37). Sexual health clinic attendance (men 1·92, 1·18–3·15; women 2·25, 1·08–4·69), HIV testing (2·91, 1·91–4·44; 1·82 1·09–3·03), and diagnoses of sexually transmitted infections (men only 2·19, 1·17–4·12) were more common among individuals reporting finding partners online after adjustment for age and number of partners. InterpretationFinding partners online was strongly associated with markers of sexual risk and health-service uptake. Online opportunities have increased since 2010–12, so these data might underestimate the importance of this social phenomenon for public health and control of sexually transmitted infections. Given the cross-sectional survey design, neither directionality nor causality can be inferred. FundingNatsal-3 was supported by grants from the Medical Research Council (G0701757) and the Wellcome Trust (084840), with contributions from the Economic and Social Research Council and Department of Health.